• Industry: Healthcare
  • Type: Survey report
  • Date: 5/21/2013

United States 

An overview of long term systems for the elderly and future direction.

Current long term care system for elderly

Public long term care is delivered through a mix of programs, with eligibility and coverage varying from one state to another. Eligibility is based mostly on income and personal resources.

Program and nature of coverage

Medicaid: a means-tested safety net for low-income elderly dependents.

Medicare: social insurance for elderly dependents aged 65 and above Private long term care insurance: purchased either by individuals or as employer-sponsored group insurance policies for long term care

Nature of benefit coverage

Medicaid: covers both home and institutional care. Some types of care are mandatory and must be covered in all states; others are optional and may be provided only in states that elect to do so.

Medicare: provides nursing homes and home health services for a short period of time, following an acute event Private long term care insurance: services covered vary according to the policy purchased.

Source of funding

Medicaid: joint federal and state funding.

Medicare: partly funded through payroll and income tax and the remaining from Medicare premiums and taxpayer funds Private long term care insurance: paid by individuals or employers (preferential tax treatment available).

Reforms initiated/ future direction

Over time, at a state and local level, the US introduced healthcare system innovations and reforms to improve access to affordable long-term elderly care and enhance cost efficiency of the healthcare system.

Initiatives such as the Program of All-Inclusive Care for the Elderly (PACE) have helped reduce hospital stay and delay assignments to nursing homes.

Recently, Congress established a Commission to recommend reforms to the current LTC system. The Commission has been established to address three key issues – long term care financing, delivery, and workforce challenges.


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